BACKGROUND: Traumatic craniocervical dissociation (CCD), which includes atlanto-occipital dissociation and vertical distraction between C1-C2, is often an immediately fatal injury that has increasingly been associated with survival to the hospital. Our aim was to identify survivors of CCD based on clinical presentation. METHODS: We retrospectively reviewed the Harborview Medical Center Trauma Registry and the King County Medical Examiners database from 2001 to 2006. Patients>or=12 y old were identified by ICD-9 code, radiographic diagnosis on lateral cervical spine films, and CT. We examined age, gender, mechanism of injury, presentation and prehospital and hospital interventions, and radiographic findings to distinguish survivors and non-survivors. RESULTS: Of 69 patients with CCD, 47 were diagnosed post mortem, 22 were diagnosed in hospital, and seven survived to discharge. When comparing survivors and non-survivors, age, gender, and injury severity score were not significant. Survivors had significantly higher GCS, and were more likely to be normotensive; none had cervical cord injury; 80% of non-survivors had a basion-dental interval (BDI) of >or=16mm. CONCLUSIONS: Trauma patients diagnosed with CCD in the ED, with cervical cord injury, requiring CPR, and with GCS of 3 will not survive their injury. Wider BDI is associated with mortality. Copyright 2010 Elsevier Inc. All rights reserved.
BACKGROUND:Traumatic craniocervical dissociation (CCD), which includes atlanto-occipital dissociation and vertical distraction between C1-C2, is often an immediately fatal injury that has increasingly been associated with survival to the hospital. Our aim was to identify survivors of CCD based on clinical presentation. METHODS: We retrospectively reviewed the Harborview Medical Center Trauma Registry and the King County Medical Examiners database from 2001 to 2006. Patients>or=12 y old were identified by ICD-9 code, radiographic diagnosis on lateral cervical spine films, and CT. We examined age, gender, mechanism of injury, presentation and prehospital and hospital interventions, and radiographic findings to distinguish survivors and non-survivors. RESULTS: Of 69 patients with CCD, 47 were diagnosed post mortem, 22 were diagnosed in hospital, and seven survived to discharge. When comparing survivors and non-survivors, age, gender, and injury severity score were not significant. Survivors had significantly higher GCS, and were more likely to be normotensive; none had cervical cord injury; 80% of non-survivors had a basion-dental interval (BDI) of >or=16mm. CONCLUSIONS:Traumapatients diagnosed with CCD in the ED, with cervical cord injury, requiring CPR, and with GCS of 3 will not survive their injury. Wider BDI is associated with mortality. Copyright 2010 Elsevier Inc. All rights reserved.
Authors: Shekhar D Khanpara; Jennifer L McCarty; Karl M Schmitt; Jessica R Stark; O Clark West; Xu Zhang; Roy F Riascos Journal: Emerg Radiol Date: 2020-07-30
Authors: Juan F Martínez-Lage; Fernando Alarcón; Raul Alfaro; Amparo Gilabert; Susana B Reyes; María-José Almagro; Antonio López López-Guerrero Journal: Childs Nerv Syst Date: 2012-09-08 Impact factor: 1.475
Authors: Matthias K Jung; Lukas Hörnig; Michael M A Stübs; Paul A Grützner; Michael Kreinest Journal: Eur J Trauma Emerg Surg Date: 2021-05-25 Impact factor: 3.693